LEARNING OBJECTIVES:  Septic arthritis  Osteomyelitis  Tuberculosis o Introduction o Etiology o Signs and symptoms o Management o Complications  References

1. CLINICAL ORTHOPEDICS
ASSIGNMENT NO. 1

2. 1
THE UNIVERSITY OF LAHORE
DEPARTMENT OF HEALTH PROFESSIONAL TECHNOLOGIES
SUBJECT: CLINICAL ORTHOPEDICS
ASSIGNED BY: MISS ANAM ZAHIR
DATE OF SUBMISSION: 16TH OCTOBER 2017
SUBMITTED BY: AMBREEN SADAF (BSOT02153003)

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LEARNING OBJECTIVES:
 Septic arthritic
 Osteomyelitis
 Tuberculosis
o Introduction
o Etiology
o Signs and symptoms
o Management
o Complications
 References

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SEPTIC ARTHITIS
Septic arthritis is infection of one or more joints by microorganisms.
CAUSES:
 Septic arthritis can be caused by bacterial, viral or fungal infections. Bacterial infection
with Staphylococcus aureus (staph) is the most common cause. Staph commonly lives
on even healthy skin.
 Septic arthritis can develop when an infection, such as a skin infection or urinary tract
infection, spreads through your bloodstream to a joint.
 Less commonly, a puncture wound, drug injection, or surgery in or near a joint can
give the germs entry into the joint space.
SIGNS AND SYMPTOMS:
 Fatigue and generalized weakness
 Fever
 Inability to move the limb with the infected joint
 Severe pain in the affected joint, especially with movement
 Swelling (increased fluid within the joint)
 Warmth (the joint is red and warm to touch because of increased blood-flow)
MANAGEMENT:
 Antibiotics and drainage of the infected joint fluid (synovial) from the joint.
 Arthroscopy is a surgical procedure by which the internal structure of a joint is
examined for diagnosis and/or treatment using a tube-like viewing instrument called an
arthroscope.
COMPLICATIONS:
 If treatment is delayed, septic arthritis can lead to joint degeneration and permanent
damage.
 Rapid clearing of the infection is critical to preserve the joint.
 If the infection is longstanding, the possibility of joint destruction exists. [a]

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OSTEOMYLITIS
Inflammation of the bone due to infection.
CAUSES:
 Osteomyelitis is caused by staphylococcus bacteria, types of germs commonly found on
the skin or in the nose of even healthy individuals.
 Germs can enter a bone in a variety of ways, including:
o The blood stream
o Infected tissue or an infected prosthetic joint
o Open wounds
SIGNS AND SYMPTOMS:
 Fever or chills
 Irritability or lethargy in young children
 Pain in the area of the infection
 Swelling
 Warmth
 Redness over the area of the infection
MANAGEMENT:
 Surgery
o Osteomyelitis surgery may include one or more of the following procedures:
 Drain the infected area
 Remove diseased bone and tissue
 Restore blood flow to the bone
 Remove any foreign objects
 Amputate the limb
 Medications
o Antibiotics
COMPLICATIONS:
 Bone death (osteonecrosis)
 Septic arthritis
 Impaired growth
 Skin cancer [b]

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TUBERCULOSIS
Bone tuberculosis (TB) is one of the forms of extra-pulmonary tuberculosis that affects the
spine, long bones and joints.
CAUSES:
 It is caused by bacteria, Mycobacterium tuberculosis.
 The joints most often involved are the:
o Ankles
o Hips
o Knees
o Spine
o Wrists
SIGNS AND SYMPTOMS:
 Decreased movement in the joints.
 Excessive sweating, especially at night.
 Joint swelling with warm, tender joints.
 Low-grade fever.
 Muscle atrophy.
 Muscle spasms.
 Numbness, tingling, or weakness below the infection (if the spine is involved).
 Weight loss or loss of appetite.
MANAGEMENT:
 Medication:
o The most commonly used drugs include:
 Isoniazid
 Rifampicin oral
 Pyrazinamide
 Ethambutol
COMPLICATIONS:
 Collapse of the vertebrae, resulting in kyphosis.
 Joint destruction.
 Nerve and spinal cord compression. [c]

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REFERENCES
a) https://www.medicinenet.com/septic_arthritis/article.htm
b) http://www.mayoclinic.org/diseases-conditions/osteomyelitis/basics/symptoms/con-
20025518
c) http://www.nytimes.com/health/guides/disease/tuberculous-arthritis/overview.html